Need a html form created

Hi,

I need a form created which will establish the following answers:
Login or Register.

And Then...
Your Name, Email Address, Password, Password Confirm

Delivery Address...
Address Line 1, Address Line 2, Town, County, Postcode

The form must display all on one page however I'm thinking it would be good to have horizontal jquery sliders such as the Opencart checkout seen here...
http://demo.opencart.com/index.php?route=checkout/cart

(You'll need to add an item to your cart to see it).

My only requirements it that it is nice clean code and fits in nicely with the application I'm building (I'll show whoever gets the job where this form is going).

Please add me in skype : vinod_vyas_dt

Hit me up with contact details if you're still looking.

Pretty easy, pm me.